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Niket Sonpal, MD Assistant Clinical Professor of Medicine Touro College of Medicine Assistant Clinical Professor of Medicine St. Georges University Department of Gastroenterology Lenox Hill Hospital-NSLIJ Health System New York, New York Conrad Fischer, MD Residency Program Director Brookdale University Medical Center New York, New York New York Chicago San Francisco Athens London Madrid Mexico City Milan New Delhi Singapore Sydney Toronto Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standard accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the editors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. Master the Wards: Internal Medicine Flashcards Copyright © 2016 by McGraw-Hill Education. All rights reserved. Printed in China. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. 1 2 3 4 5 6 7 8 9 0 DSSIDSS 20 19 18 17 16 15 ISBN: 978-0-07-183466-7 MHID: 0-07-183466-4 This book was set in Chaparral Pro by Cenveo® Publisher Services. The editors were Catherine A. Johnson and Christina M. Thomas. The production supervisor was Rick Ruzycka. Project management was provided by Namita Gahtori, Cenveo Publisher Services. RR Donnelley/Shenzhen was printer and binder. C 0 N J:-E-IY J: S -- --- · ---------- -.. - --- ---=- - -- -- · - · - - - ~ 1 Cardiology 2 Infectious Disease 3 Gastroenterology 4 Rheumatology 5 Pulmonary 6 Endocrinology 7 Nephrology 8 Hematology 9 Oncology 10 Hepatology 11 Preventative Medicine 12 Emergency Medicine 13 Neurology 14 Radiology The author would like to dedicate this publication to Conrad Fischer, MD - a scholar, educator, friend, and mentor. Your teachings both in life and medicine have made me the physician I am today. For that, I am forever thankful. -Niket Sonpal, MD HOW TO GET THE MOST OUT OF m··I:I'E s·E'· ..· R· .. '"'<·~· =·-c.,=.· ···"·---~-···-·· · ··E·I!·A~s· t:t·E i~ff. o· s£~·,···=--·········-.-····· ~-""' Master the Wards: Internal Medicine Flashcards have been designed to serve as a "one-stop" review of the 201 cases you are most likely to see during your medicine clerkship, and be tested on during your shelf exam. Each flashcard provides a common presenting case history (vignette) and clinical-pathologic features, combined with questions commonly asked by your senior physicians, and on board exams. On the back of each card, you'll find the most up to date diagnostic pearls, tests, and therapeutic algorithms for each disease. The deck is color-coded by system, so you can carry just what you need and organize your study for maximum results-take them on rounds, take them on the subway, or use them at home. They will fit in your lab coat, and you can become the all-star you are meant to be on rounds. Niket Sonpal, MD - _. _______ ___________ .---- -- ----- -- A.BBRE.VJAl:t0--1~.5--- These are the abbreviations used commonly through these flash cards: ABPA Allergic bronchopulmonary aspergillosis COPD Chronic obstructive pulmonary disease ACTH Adrenocorticotropic hormone CTS Carpal tunnel syndrome ADEK A, D, E, and K (vitamins) CSF Cerebrospinal fluid ADH Antidiuretic hormone CT Computed tomography AHase Antihyaluronidase 01 Diabetes insipidus ANA Antinuclear antibodies DIP Distal interphalangeal anti-CCP Anti-cyclic citrullinated peptide DMARD Disease-modifying anti-rheumatic drug anti-NAD Antinicotinamide adenine dinucleotidase EF Ejection fraction AS Ankylosing spondylitis EHEC Enterohemorrhagic E. coli ASO Antistreptolysin EGO Esophagogastroduodenoscopy ATN Acute tubular necrosis EMG Electromyography ATRA All trans-retinoic acid ERCP Endoscopic retrograde cholangiopancreatography CAG Cytosine-adenine-guanine EUS-FNA Endoscopic ultrasound with fine-needle aspiration cAMP Cyclic adenosine monophosphate GERD Gastroesophageal reflux disease CAP Community-acquired pneumonia HAART Highly active antiretroviral therapy CAUTI Catheter-associated UTI HE Hepatic encephalopathy CD! Central diabetes insipidus HIT Heparin-induced thrombocytopenia CFTR Cystic fibrosis transmembrane conductance HOCM Hypertrophic obstructive cardiomyopathy regulator HUS Hemolytic uremic syndrome CHF Congestive heart failure INH Isoniazid CKD Chronic kidney disease INR International normalized ratio CNS Central nervous system IVIG Intravenous immunoglobulin CPAP Continuous positive airway pressure LABA Long-acting beta-agonist CPK Creatine phosphokinase LDCT Low-dose computed tomography CMT Cervical motion tenderness LES Lower esophageal sphincter LGV Lymphogranuloma venereum PTT Partial thromboplastin time LP Lumbar puncture PUD Peptic ulcer disease MCP Metacarpophalangeal RA Rheumatoid arthritis MCV Mean corpuscular volume RPR Rapid plasma reagin MCHC Mean corpuscular hemoglobin concentration SABA Short-acting beta-agonist MENl Multiple endocrine neoplasia type 1 SPEP Serum protein electrophoresis MI Myocardial infarction STEM! ST segment elevation myocardial infarction MR Mitral regurgitation STis Sexually transmitted infections MRI Magnetic resonance imaging SI Sacroiliac MRSA Methicillin-resistant Staphylococcus aureus SVT Supraventricular tachycardia MS Mitral stenosis TA Temporal arteritis MUGA Multigated acquisition TB Tuberculosis NAAT Nucleic acid amplification test TIA Transient ischemic attack NDI Nephrogenic diabetes insipidus TIBC Total iron binding capacity NSAIDs Nonsteroidal antiinflammatory drugs TIPS Transjugular intrahepatic portosystemic shunt OCP Oral contraceptive pill TMP-SMX Trimethoprim-sulfamethoxazole PAN Polyarteritis nodosa TNF Tumor necrosis factor P-ANCA Perinuclear anti-neutrophil cytoplasmic antibodies TRAP Tartrate resistant acid phosphatase PAS Periodic acid-Schiff TRH Thyroid releasing hormone PBC Primary biliary cirrhosis TSH Thyroid stimulating hormone PEA Pulseless electrical activity TTE Transthoracic echocardiogram PF4 Platelet factor 4 TTP Thrombotic thrombocytopenic purpura PFT Pulmonary function test USPSTF U.S. Preventive Services Task Force PIP Proximal interphalangeal UTI Urinary tract infection PMH Past medical history VDRL Venereal disease research laboratory PMR Polyrnyalgia rheumatic VMA Vanillylmandelic acid PPD Purified protein derivative VWD Von Willebrand disease PPI Proton pump inhibitor VWF Von Willebrand factor PSA Prostate-specific antigen WPW Wolff-Parkinson-White PSGN Post streptococcal glomerulonephritis ZES Zollinger-Ellison syndrome PT Prothrombin time ZK Zenker diverticulum A 4 7 -year-old man presents to the office with intermittent • What is the most common substernal chest pain for the last several weeks, sometimes risk factor for coronary artery disease? with exertion and sometimes at rest, with no fixed pattern. He also complains of nausea. • What is the worst risk factor for coronary disease? • What is the most easily modified risk factor for coronary disease? • What 3 features of chest pain on history or physical on the Boards tell you for sure that the pain is not ischemic in nature?